BackgroundEarly diagnosis and prompt treatment are critical to reducing overall morbidity and mortality associated with dengue fever. Thus, to better understand the condition, the present study was conducted to assess the clinical signs and symptomatology associated with dengue fever in patients in a tertiary care hospital. MethodsThis prospective observational study was conducted at a tertiary care hospital in Karachi, Pakistan between July and December 2021. All patients who tested positive for the dengue virus either based on antigen or antibodies were included in the study. Convenient sampling was used. A structured proforma was used for data collection. Microsoft Excel (Microsoft Corporation, Redmond, WA) and Statistical Package for the Social Sciences (SPSS, IBM Corp., Armonk, NY) were used for the entry and analysis of data, respectively. ResultsMore than half of the patients were suffering from fever (82.5%), headache/body ache/joint pain (80.5%), and vomiting (55%). Bleeding was observed in 16 (8%) patients and was directly related to platelet count (OR: 0.981; 95% CI: 0.971-0.992), and more than half of the patients (56%) required platelet transfusion. Laboratory values included a mean platelet count of 145.22 ± 90.36 thousand, a mean total leukocyte count (TLC) of 6.87 ± 5.76 thousand, and a mean hemoglobin level of 13.71 ± 2.11 g/dl. Of the patients, 171 (85.5%) individuals tested positive for antigen nonstructural protein 1 (Ns1Ag), and 68 (34%) tested positive for either immunoglobulin G (IgG) or immunoglobulin M (IgM), or both dengue-specific antibodies. Those with dengue-specific antibodies were less likely to bleed as 6.2% were IgG and IgM positive and 31.2% were positive for both antibodies. The regression model showed a significant relationship between bleeding and platelet transfusion (p < 0.001), hospital stay (p < 0.005), and diarrhea (p < 0.001). ConclusionIn conclusion, the study revealed that males were more frequently infected with the virus as compared to females. Furthermore, fever, headache/joint pain/body aches, diarrhea, and low platelet count are the major clinical and laboratory outcomes. Patients with a low level of platelets are more prone to bleeding, and platelet transfusion increased survival chances in such patients.

Background: The incidence of maternal mortality and morbidity related to the termination of unwanted pregnancy in Pakistan is rising at an alarming rate. Instant Postpartum insertion of intra- uterine contraceptive device (PPIUCD) is an effective contraceptive measure to reduce unexpected pregnancy and its associated complications in developing countries like Pakistan. Methods: The current study was conducted in a public sector hospital in Karachi with a total of 7314 pregnant women counselled for insertion of PPIUCD antenatally. Out of which 5682 women agreed to the insertion and 1632 refused the procedure, mostly due to unfamiliarity with PPIUCD insertion. PPIUCD was inserted within 48 hours of delivery in 1441 patients and they were followed for 6 months onwards. Results: Total postpartum insertions were 1441 which was found to be an effective measure with the continuation rate of 91% among 785 followed up cases. Postpartum IUCD insertion was found as an effective, satisfactory and convenient practice for the women of developing countries like Pakistan, to get an on-time appropriate contraceptive measure. Conclusion: PPIUCD was found to have high retention and low expulsion rate and its efficacy can be improved further by proper training and skills of healthcare professionals. In this regard, appropriate strategies should be formulated and implemented at the statutory level by increasing social awareness and practice of using PPIUCD by health care providers to reduce undesired pregnancies.

Objective: Determining the predictive significance of first trimester serum uric acid for the development of gestational diabetes mellitus (GDM) in pregnant women. Study Design: Case Control study. Setting: Department Gynecology and Obstetrics, Shaheed Muhtrama Benazir Bhutto Medical College Layari General Hospital Karachi. Period: March 2017 to December 2018. Material & Methods: Sample of 172 pregnant women in first trimester (<14 weeks gestation) were divided into; 72 controls and 72 cases through purposive sampling. Pregnant women with fasting blood glucose (FBG) ≥100 mg/dl were defined as GDM. FBG was estimated by hexokinase and uric acid by enzymatic method (uricase) using commercial colorimetric assay (Nikken Seal Co., Ltd, Japan). Data was analyzed on SPSS software 21.0 (IBM, Inc USA) at 95% CI. Results: Maternal age of control and cases was noted 30.23±1.47 and 30.14±1.41 years. Gestational age in controls was 9.80±2.23 weeks compared to 10.37±2.34 weeks in cases. Serum Uric acid in control was 3.19±0.49 mg/dl compared to 3.73±0.43 mg/dl in cases (P=0.0001). Logistic regression analysis model generated ROC curve shows excellent area under the curve (AUC) of 0.92 [95% CI (0.87-0.97)] with a diagnostic threshold of 3.91 mg/dl for uric acid. At this Uric acid threshold, the specificity and sensitivity was 96.4% and 69.7% respectively (P=0.0001). Conclusion: It is concluded first trimester serum uric acid may be used for predicting the future development of gestational diabetes mellitus.

To evaluate the predictive value of Red blood cell distribution width (RDW) for the iron deficiency anemia in children. Study Design: Cross sectional study. Place and Duration: Department of Paediatrics, Layari General Hospital Shaheed Muhtrama Benazir Bhutto Medical College from December 2015 to March 2016. Methodology: A sample of 100 children (53 male and 47 female) was selected through non-probability (purposive sampling). 5 ml venous blood was collected, 3 ml was shifted to EDTA containing vacutainers and remaining was processed and centrifuged to separate sera. Complete blood counts and iron profile were performed. Data of cases and controls was analyzed on Statistix 10.0 software (USA) (P ≤0.05). Results: Severe iron deficiency and iron deficiency anemia were noted. Serum Iron, TIBC and Ferritin were noted as 63.49±32.94 and 76.06±40.38 μg/dl, 468.7±142.2 and 445.5±135.2 μg/ dl, & 36.2±14.12 and 43.2±13.5 ng/dl respectively. RDW proved a sensitivity and specificity of 78% and 56% respectively (0.001). Conclusion: We observed severe iron deficiency anemia in children and Red blood cell distribution width showed high sensivity in predicting iron deficiency anemia.

To determine the serum zinc levels in children with simple febrile seizures reporting at a tertiary care hospital of Sindh.